Provider Type Icon

MATRIX MENTAL HEALTH ALLIANCE LLC NPI 1700929940


NPI Information

NPI: 1700929940
Provider Name: MATRIX MENTAL HEALTH ALLIANCE LLC

Doing Business As: CRISYS

Classification: Psychologist - 103TB0200X
Entity Type: Organization

Specialization: Cognitive & Behavioral

Address:
5820 E WT HARRIS BLVD
SUITE 211
CHARLOTTE, NC
ZIP 28215
Phone: (704) 566-3410
Get Directions

MATRIX MENTAL HEALTH ALLIANCE LLC is a cognitive and behavioral psychologist in Charlotte, NC. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. MATRIX MENTAL HEALTH ALLIANCE LLC NPI is 1700929940. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Crisys.

The provider's business location address is:

5820 E WT HARRIS BLVD
SUITE 211
CHARLOTTE, NC
ZIP 28215-541
Phone: (704) 566-3410
Fax: (704) 537-1226

The provider's authorized official is Fred B Chanteau .
The authorized official title is Ceo and has the following contact phone number (301) 572-6585.

The enumeration date for this NPI number is 2/15/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TB0200XPsychologistCognitive & BehavioralYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
18301491MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.